The One Thing You Should Do Today if You’re at Risk for a Heart Attack

1_lp5iquleQM96kgSkir-iegAs a heart attack survivor, I’ve had the opportunity to speak to hundreds of people about my experience. Whether I’m sharing the story over dinner with friends or blogging about the day of my cardiac event, one particular question always seems to pop up: what can I do to make sure this doesn’t happen to me?

People have preconceived notions about who is at risk for a heart attack and unfortunately these assumptions are usually very wrong. Most of us think heart attacks only happen to overweight people, or sedentary people, or smokers. People look at me and see themselves and it freaks them out. True, I didn’t have any outwardly apparent risks for heart disease, but below the surface I was a ticking time bomb. My triglycerides were significantly elevated. My high-density lipoprotein (HDL or good cholesterol) was low. My blood sugar was borderline high. My family history was chock-full of heart disease. I had what is commonly known as Metabolic Syndrome or Syndrome X — a cluster of conditions that increase the risk of heart disease, stroke, and diabetes.

Metabolic syndrome occurs when a person has three or more of the following measurements:

  • Abdominal obesity (Waist circumference of greater than 40 inches in men, and greater than 35 inches in women)
  • Triglyceride level of 150 milligrams per deciliter of blood (mg/dL) or greater
  • HDL cholesterol of less than 40 mg/dL in men or less than 50 mg/dL in women
  • Systolic blood pressure (top number) of 130 millimeters of mercury (mm Hg) or greater, or diastolic blood pressure (bottom number) of 85 mm Hg or greater
  • Fasting glucose of 100 mg/dL or greater

I had three of the above symptoms, all hidden below the surface. And I knew about it. And I tried to fix it on and off for years by adjusting my diet and exercising more. But I still had a heart attack at 45.

What could I have done to avoid having a heart attack?

When people ask me that question (and they always do), I say the same thing: if you have three or more of the signs of Metabolic Syndrome, or a family history of heart disease, and are over the age of 40 — go get a coronary artery calcium (CAC) scan.

Right now you’re probably thinking how come you’ve never heard of this test. Is this something new? It’s not new, and has been around since the early 90s, but for a long time it has been seen by many cardiologists as not reliable enough to recommend for their patients. But that is changing, as discussed in a newly published article by Harvard Health Publishing, and as evidenced by the growing number of hospitals and diagnostic labs that offer the test.

“CAC results can help identify a person’s possible risk for heart attack or stroke, even if that person doesn’t have the obvious risk factors or symptoms,” says Dr. Jorge Plutzky, director of preventive cardiology at Harvard-affiliated Brigham and Women’s Hospital. “It can be a way for some people to get the necessary treatment early and hopefully head off a serious cardiac event.”

If I’d had a CAC at a local hospital prior to having a heart attack on Oct. 15, 2011 it’s very likely the test would have shown that I had a severe blockage in my left anterior descending artery. Instead of having the heart attack that nearly killed me and permanently damaged my heart, the test results would have tipped off doctors that I was in danger and they could have gone in and stented the artery before the damage was done.

I’m not saying everyone should run out and get a CAC. But if you are at risk for heart disease it’s a valuable tool in the arsenal and it just might save your life. And while insurance companies aren’t yet sold on its value (and since when have insurance companies cared about your health), it’s a relatively inexpensive test and in most places you don’t even need a referral from a doctor. That’s right, you can use Google to find a test location near you, make an appointment, and plop down less than $100 for a 15 minute non-invasive test that might save your life.

That seems like a small price to pay for peace of mind.